Last month, the nation was shocked by news of a child’s death by choking on chewy candy. This incident reminds us of the importance of awareness regarding first aid in choking situations, especially among children.

When someone is choking, it means their airway is blocked by an object, preventing oxygen from reaching the brain. Should oxygen deprivation continue for more than four minutes, brain damage may occur, and it can be fatal.

So, what actions should be taken in such a situation? The rescuer should remain calm and act immediately, administering first aid and getting help as soon as possible. Bystanders can also assist by calling 999 for emergency services.

Some signs that a child may be choking include:

• persistent coughing without an obvious reason;
• difficulty breathing or gasping for air;
• wheezing sounds similar to asthma patients;
• panicked reactions and clutching at the throat;
• inability to speak clearly or produce vocalisations;
• losing consciousness or turning blue in the face.

Here are some first-aid manoeuvres if the victim is still conscious:

Infants under 1 year old:

1. Lay the baby face down on your arm, along your thigh. Hold the baby securely, making the child’s head is lower than the body.
2. Using your other hand, give five back blows between the shoulder blades.
3. Turn the baby onto their back and check if the object has been expelled. If visible, remove it carefully, making sure not to push it further in.
4. If the baby continues to show signs of choking, place two fingers in the middle of the chest and perform five chest thrusts.
5. Repeat back blows and chest thrusts alternately until the object is expelled. Stop if the baby becomes unconscious and seek emergency aid.

Children aged 1-12:

1. Ask if the victim can speak or cough. If they can still cough, encourage repeated strong coughing to expel the object.
2. If the cough is weak or they cannot cough, deliver five back blows between the shoulder blades with the head in a lowered position.
3. If unsuccessful, perform abdominal thrusts (Heimlich manoeuvre) below the navel until the object is expelled.
4. If the object is visible in the mouth, remove it carefully without pushing it further in.

If the victim is unconscious and not breathing:

1. Lay the victim on the floor and open the airway using the head tilt-chin lift technique.
2. Check the victim’s mouth and remove any visible object.
3. If the victim is still not breathing after the object is removed, give rescue breaths by blowing into their mouth for one second.
4. Observe chest movement after rescue breaths.
5. Perform chest compressions if necessary.

The public is encouraged to undergo first-aid training as it may help save lives. With the right knowledge, individuals can act confidently and effectively in emergency situations.

Ultimately, prevention is more important than treatment. So, ensure food is given in appropriate sizes and chewed properly, and prevent young people from playing or joking while eating.

Remember, the safety of children should be the responsibility of adults around them.

This article was written by Dr Shahrul Nizam Ahmad Zamzali, consultant physician at KPJ Ampang Puteri Specialist Hospital.